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目的:探讨高血压性脑出血(HIH)患者是否存在胰岛素抵抗(IR)与高胰岛紊血症(HIS),以及IR与患者病情、预后的关系。方法:测定了56例高血压性脑出血患者及37例原发性高血压患者、49例健康人的血糖(FPG)与血清胰岛素水平(FINS),同时采用胰岛素敏感性指数(ISI)方法进行计算,3个月后随访高血压性脑出血患者,进行日常生活能力(ADL)Barthel指数评分。结果:高血压性脑出血患者FPG及FINS增多明显高于对照组(P<0.001,P<0.001),其ISI较对照明显减低(P<0.001)。高血压性脑出血患者轻型组与重型组的FPG、FINS、ISI比较也存在显著性差异(P<0.001,P<0.05,P<0.001)。随访高血压性脑出血患者轻型组ADL评分明显高于重型组。结论:高血压性脑出血患者存在IR及HIS,其胰岛索水平及IR程度与患者病情、预后有关。建议对高血压性脑出血患者的血糖水平升高与IR及ISI下降者应积极使用改善胰岛素敏感性的药物治疗。
Objective: To investigate the relationship between insulin resistance (IR) and hyperinsulinism (HIS) in patients with hypertensive intracerebral hemorrhage (HIH), and the relationship between IR and disease and prognosis. Methods: The blood glucose (FPG) and serum insulin (FINS) were determined in 56 patients with hypertensive intracerebral hemorrhage and 37 patients with essential hypertension. The insulin sensitivity index (ISI) The patients were followed up for 3 months with hypertensive intracerebral hemorrhage and their ADL Barthel index was calculated. Results: The levels of FPG and FINS in patients with hypertensive intracerebral hemorrhage were significantly higher than those in the control group (P <0.001, P <0.001), and the ISI was significantly lower than that in the control group (P <0.001). The levels of FPG, FINS and ISI in hypertensive intracerebral hemorrhage patients were also significantly different between light and heavy groups (P <0.001, P <0.05, P <0.001). Follow-up of patients with hypertensive cerebral hemorrhage light group ADL score was significantly higher than the heavy group. Conclusion: There are IR and HIS in patients with hypertensive intracerebral hemorrhage. The level of IR and the degree of IR are related to the patient’s condition and prognosis. Proposed hypertensive cerebral hemorrhage in patients with elevated blood glucose levels and IR and ISI decline should be actively used to improve insulin sensitivity of drug treatment.